HESI EXIT EXAM Actual Exam 2026/2027 |
Official Exam – Complete Q&A with Rationales –
Pass Guaranteed - A+ Graded
Total Questions: 160 | Time: 240 min | Pass: 850 scaled (75%)
TABLE OF CONTENTS
Section 1 | Safe and Effective Care Environment | Q1 – Q40
Section 2 | Health Promotion and Maintenance | Q41 – Q80
Section 3 | Psychosocial Integrity | Q81 – Q120
Section 4 | Physiological Integrity | Q121 – Q160
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SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT Q1 – Q40
══════════════════════════════════════
Question 1 of 160
A 68-year-old client is admitted with a MRSA wound infection. The nurse initiates
contact precautions and prepares the room. Which action by the nurse demonstrates
proper infection control practice?
A. Placing the client in a negative-pressure room
B. Wearing an N95 respirator for all client contact
C. Performing hand hygiene before and after glove removal ✓ CORRECT
D. Keeping the client’s chart inside the isolation room at all times
Correct Answer: C
Rationale: Hand hygiene is the single most effective way to prevent pathogen
transmission, and it must occur both before donning and after doffing gloves to protect
the client and the nurse. Option A is incorrect because MRSA requires contact
precautions, not airborne isolation, which is the only indication for negative-pressure
,rooms. Option B confuses MRSA with airborne diseases like tuberculosis that require
N95 masks.
Question 2 of 160
During morning rounds on a medical-surgical unit, the RN reviews the assignments for
three clients. Which task is most appropriate to delegate to an experienced LPN?
A. Administering an enema to a stable client preparing for colonoscopy ✓ CORRECT
B. Assessing a newly admitted client with chest pain and shortness of breath
C. Teaching a newly diagnosed diabetic client how to administer insulin
D. Evaluating the effectiveness of pain medication given two hours ago
Correct Answer: A
Rationale: LPN scope of practice includes performing standardized procedures such as
enemas for stable clients with predictable outcomes. Assessment of unstable clients,
initial diabetic teaching, and evaluation of medication effectiveness require nursing
judgment and fall within the RN scope of practice.
Question 3 of 160
A 79-year-old client with a history of syncope is being transferred from bed to chair. The
nurse uses a gait belt and a second staff member to assist. What is the primary
rationale for this intervention?
A. To increase the client’s independence during the transfer
B. To allow the nurse to maintain proper body mechanics alone
C. To satisfy the hospital’s documentation requirements for all transfers
D. To prevent falls and injury to both the client and staff ✓ CORRECT
Correct Answer: D
Rationale: Gait belts and assistive personnel reduce fall risk for unsteady clients and
prevent musculoskeletal injuries to staff during transfers. Option B is incorrect because
,a gait belt does not eliminate the need for assistive devices or team lifting for
dependent clients.
Question 4 of 160
A nurse in the emergency department receives a phone call from a local news reporter
asking about a celebrity client admitted after a motor vehicle crash. The nurse’s most
appropriate response is which of the following?
A. Confirming that the celebrity is receiving excellent care and will recover soon
B. Stating that the hospital cannot disclose any patient information without consent ✓
CORRECT
C. Providing a brief general update while omitting specific medical details
D. Transferring the call to the client’s family for their approval to share information
Correct Answer: B
Rationale: HIPAA mandates that healthcare providers protect all identifiable health
information and refrain from confirming or denying a client’s presence without explicit
authorization. Option A violates privacy laws by confirming admission and implying
prognosis, while option C still constitutes an unauthorized disclosure of protected
information.
Question 5 of 160
A nurse prepares to administer digoxin 0.25 mg PO to a client with atrial fibrillation. The
client’s apical pulse is 52 beats per minute. What is the nurse’s priority action?
A. Withholding the dose and notifying the prescriber ✓ CORRECT
B. Administering the dose and rechecking the pulse in one hour
C. Giving half the dose and documenting the pulse finding
D. Rechecking the radial pulse for a full minute before deciding
Correct Answer: A
, Rationale: Digoxin is contraindicated when the apical pulse is below 60 beats per
minute due to the risk of severe bradycardia and heart block. Option B is dangerous
because administering the full dose could precipitate life-threatening bradyarrhythmia in
a client with a pulse of 52.
Question 6 of 160
A 54-year-old client with dementia becomes agitated and attempts to pull out the
nasogastric tube. The provider orders wrist restraints. Before applying them, what
should the nurse do first?
A. Apply the restraints and then offer a distraction such as music
B. Ask the family to hold the client’s hands until sedation takes effect
C. Attempt less restrictive alternatives such as mittens or a sitter ✓ CORRECT
D. Document that the client is a danger to self and apply immediately
Correct Answer: C
Rationale: The Joint Commission and CMS require that restraints be used only as a last
resort after less restrictive measures have been attempted and failed. Option D violates
regulatory standards by skipping the assessment for alternatives, and mittens or
one-to-one observation often sufficiently protect lines without the risks associated with
physical restraints.
Question 7 of 160
Thirty minutes after starting a unit of packed red blood cells, a client reports chills and
low back pain. The nurse notes a temperature of 38.9°C and tachycardia. What is the
nurse’s immediate priority?
A. Administering acetaminophen and continuing the transfusion slowly
B. Rechecking the vital signs in fifteen minutes while observing closely
C. Notifying the blood bank and asking for a different blood type
D. Stopping the transfusion and maintaining the line with normal saline ✓ CORRECT
Official Exam – Complete Q&A with Rationales –
Pass Guaranteed - A+ Graded
Total Questions: 160 | Time: 240 min | Pass: 850 scaled (75%)
TABLE OF CONTENTS
Section 1 | Safe and Effective Care Environment | Q1 – Q40
Section 2 | Health Promotion and Maintenance | Q41 – Q80
Section 3 | Psychosocial Integrity | Q81 – Q120
Section 4 | Physiological Integrity | Q121 – Q160
══════════════════════════════════════
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT Q1 – Q40
══════════════════════════════════════
Question 1 of 160
A 68-year-old client is admitted with a MRSA wound infection. The nurse initiates
contact precautions and prepares the room. Which action by the nurse demonstrates
proper infection control practice?
A. Placing the client in a negative-pressure room
B. Wearing an N95 respirator for all client contact
C. Performing hand hygiene before and after glove removal ✓ CORRECT
D. Keeping the client’s chart inside the isolation room at all times
Correct Answer: C
Rationale: Hand hygiene is the single most effective way to prevent pathogen
transmission, and it must occur both before donning and after doffing gloves to protect
the client and the nurse. Option A is incorrect because MRSA requires contact
precautions, not airborne isolation, which is the only indication for negative-pressure
,rooms. Option B confuses MRSA with airborne diseases like tuberculosis that require
N95 masks.
Question 2 of 160
During morning rounds on a medical-surgical unit, the RN reviews the assignments for
three clients. Which task is most appropriate to delegate to an experienced LPN?
A. Administering an enema to a stable client preparing for colonoscopy ✓ CORRECT
B. Assessing a newly admitted client with chest pain and shortness of breath
C. Teaching a newly diagnosed diabetic client how to administer insulin
D. Evaluating the effectiveness of pain medication given two hours ago
Correct Answer: A
Rationale: LPN scope of practice includes performing standardized procedures such as
enemas for stable clients with predictable outcomes. Assessment of unstable clients,
initial diabetic teaching, and evaluation of medication effectiveness require nursing
judgment and fall within the RN scope of practice.
Question 3 of 160
A 79-year-old client with a history of syncope is being transferred from bed to chair. The
nurse uses a gait belt and a second staff member to assist. What is the primary
rationale for this intervention?
A. To increase the client’s independence during the transfer
B. To allow the nurse to maintain proper body mechanics alone
C. To satisfy the hospital’s documentation requirements for all transfers
D. To prevent falls and injury to both the client and staff ✓ CORRECT
Correct Answer: D
Rationale: Gait belts and assistive personnel reduce fall risk for unsteady clients and
prevent musculoskeletal injuries to staff during transfers. Option B is incorrect because
,a gait belt does not eliminate the need for assistive devices or team lifting for
dependent clients.
Question 4 of 160
A nurse in the emergency department receives a phone call from a local news reporter
asking about a celebrity client admitted after a motor vehicle crash. The nurse’s most
appropriate response is which of the following?
A. Confirming that the celebrity is receiving excellent care and will recover soon
B. Stating that the hospital cannot disclose any patient information without consent ✓
CORRECT
C. Providing a brief general update while omitting specific medical details
D. Transferring the call to the client’s family for their approval to share information
Correct Answer: B
Rationale: HIPAA mandates that healthcare providers protect all identifiable health
information and refrain from confirming or denying a client’s presence without explicit
authorization. Option A violates privacy laws by confirming admission and implying
prognosis, while option C still constitutes an unauthorized disclosure of protected
information.
Question 5 of 160
A nurse prepares to administer digoxin 0.25 mg PO to a client with atrial fibrillation. The
client’s apical pulse is 52 beats per minute. What is the nurse’s priority action?
A. Withholding the dose and notifying the prescriber ✓ CORRECT
B. Administering the dose and rechecking the pulse in one hour
C. Giving half the dose and documenting the pulse finding
D. Rechecking the radial pulse for a full minute before deciding
Correct Answer: A
, Rationale: Digoxin is contraindicated when the apical pulse is below 60 beats per
minute due to the risk of severe bradycardia and heart block. Option B is dangerous
because administering the full dose could precipitate life-threatening bradyarrhythmia in
a client with a pulse of 52.
Question 6 of 160
A 54-year-old client with dementia becomes agitated and attempts to pull out the
nasogastric tube. The provider orders wrist restraints. Before applying them, what
should the nurse do first?
A. Apply the restraints and then offer a distraction such as music
B. Ask the family to hold the client’s hands until sedation takes effect
C. Attempt less restrictive alternatives such as mittens or a sitter ✓ CORRECT
D. Document that the client is a danger to self and apply immediately
Correct Answer: C
Rationale: The Joint Commission and CMS require that restraints be used only as a last
resort after less restrictive measures have been attempted and failed. Option D violates
regulatory standards by skipping the assessment for alternatives, and mittens or
one-to-one observation often sufficiently protect lines without the risks associated with
physical restraints.
Question 7 of 160
Thirty minutes after starting a unit of packed red blood cells, a client reports chills and
low back pain. The nurse notes a temperature of 38.9°C and tachycardia. What is the
nurse’s immediate priority?
A. Administering acetaminophen and continuing the transfusion slowly
B. Rechecking the vital signs in fifteen minutes while observing closely
C. Notifying the blood bank and asking for a different blood type
D. Stopping the transfusion and maintaining the line with normal saline ✓ CORRECT
